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Chapter 28: Psychotherapies
Table 28.3-3
Twenty Therapeutic Factors in Group Psychotherapy
Factor
Definition
Abreaction
A process by which repressed material, particularly a painful experience or conflict, is brought back to
consciousness. In the process, the person not only recalls but relives the material, which is accompanied by the
appropriate emotional response; insight usually results from the experience.
Acceptance
The feeling of being accepted by other members of the group; differences of opinion are tolerated, and there is an
absence of censure.
Altruism
The act of one member helping another; putting another person’s need before one’s own and learning that there is
value in giving to others. The term was originated by Auguste Comte (1798–1857), and Sigmund Freud believed
it was a major factor in establishing group cohesion and community feeling.
Catharsis
The expression of ideas, thoughts, and suppressed material that is accompanied by an emotional response that
produces a state of relief in the patient.
Cohesion
The sense that the group is working together toward a common goal; also referred to as a sense of “we-ness”;
believed to be the most important factor related to positive therapeutic effects.
Consensual
validation
Confirmation of reality by comparing one’s own conceptualizations with those of other group members;
interpersonal distortions are thereby corrected. The term was introduced by Harry Stack Sullivan; Trigant Burrow
had used the phrase “consensual observation” to refer to the same phenomenon.
Contagion
The process in which the expression of emotion by one member stimulates the awareness of a similar emotion in
another member.
Corrective familial
experience
The group re-creates the family of origin for some members who can work through original conflicts
psychologically through group interaction (e.g., sibling rivalry, anger toward parents).
Empathy
The capacity of a group member to put himself or herself into the psychological frame of reference of another
group member and thereby understand his or her thinking, feeling, or behavior.
Identification
An unconscious defense mechanism in which the person incorporates the characteristics and the qualities of
another person or object into his or her ego system.
Imitation
The conscious emulation or modeling of one’s behavior after that of another (also called
role modeling
); also
known as spectator therapy, as one patient learns from another.
Insight
Conscious awareness and understanding of one’s own psychodynamics and symptoms of maladaptive behavior.
Most therapists distinguish two types: (1) intellectual insight—knowledge and awareness without any changes
in maladaptive behavior; (2) emotional insight—awareness and understanding leading to positive changes in
personality and behavior.
Inspiration
The process of imparting a sense of optimism to group members; the ability to recognize that one has the capacity
to overcome problem; also known as instillation of hope.
Interaction
The free and open exchange of ideas and feelings among group members; effective interaction is emotionally
charged.
Interpretation
The process during which the group leader formulates the meaning or significance of a patient’s resistance,
defenses, and symbols; the result is that the patient has a cognitive framework within which to understand his
or her behavior.
Learning
Patients acquire knowledge about new areas, such as social skills and sexual behavior; they receive advice, obtain
guidance, and attempt to influence and are influenced by other group members.
Reality testing
Ability of the person to evaluate objectively the world outside the self; includes the capacity to perceive oneself
and other group members accurately.
See also
Consensual validation.
Transference
Projection of feelings, thoughts, and wishes onto the therapist, who has come to represent an object from the
patient’s past. Such reactions, while perhaps appropriate for the condition prevaling in the patient’s earlier life,
are inappropriate and anachronistic when applied to the therapist in the present. Patients in the group may also
direct such feelings toward one another, a process called
multiple transferences.
Universalization The awareness of the patient that he or she is not alone in having problems; others share similar complaints or
difficulties in learning; the patient is not unique.
Ventilation
The expression of suppressed feelings, ideas, or events to other group members; the sharing of personal secrets
that ameliorate a sense of sin or guilt (also referred to as
self-disclosure
).
of themselves through their interactions with the other group
members, who provide feedback about their behavior; to pro-
vide patients with improved interpersonal and social skills; to
help the members adapt to an inpatient setting; and to improve
communication between patients and staff. In addition, one type
of group meeting is attended only by inpatient hospital staff
and is meant to improve communication among the staff mem-
bers and to provide mutual support and encouragement in their
day-to-day work with patients. Community meetings and team
meetings are more helpful for dealing with patient treatment
problems than they are for providing insight-oriented therapy,
which is the province of the small-group therapy meeting.
Group Composition
Two key factors of inpatient groups common to all short-
term therapies are the heterogeneity of the members and the
rapid turnover of patients. Outside the hospital, therapists
have large caseloads from which to select patients for group
therapy. On the ward, therapists have a limited number of
